| NPI | 1841529047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ 223567) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN-330494-L) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: PA 084384) | |
| Enumeration Date | 2009-12-17 |
| Last Update Date | 2022-06-08 |